RFDMedic3D

I was involved in an intersection MVC the other week while responding to CVA symptoms. The light had just gone red for my direction and I slowed to a crawl to ensure everyone in the opposing lane saw me, they had, or so I thought. As I proceded thru the intersection, a car came racing into the intersection and hit my ambulance right at the rear wheels. This caused us to tip up onto the passenger side wheels. As I looked out the windshield and driver's window, I thought to my self, "WOW! we're really high, wait a minute, this unit isn't that big!!!" We then returned to all our wheels with a "BANG!" After checking myself and my partner, we checked the other driver and called in to dispatch. We were both just shaken up and the other driver had a minor cut on the forehead, their car however wasn't as lucky. I was just wondering if anyone else had crazy things go through their heads during stressful situations.

Have a bit too much time on you hands???

Regret. We all have them. I'm sure that if I was told I had only a very limited time to live, I would die with many regrets. What would I do? Who would I tell? that would depend on the time frame. If it were days, my list of things would be shorter. My Family would be told no matter what. However, I would insist that they go on as if nothing was wrong. They must continue to live, hopefully a long time after I am gone, and hovering around me while I spend my last moments here will just hinder their future. I would like to spend free time with them.

While I agreee that this entire incident may have been poorly conceived, it does fall into that area of "P.C. Behavior." Our country, and our world, has become so wrapped up in trying to make everyone happy that you can't tell a joke on duty these days wothout someone taking offense. If this picture offends, don't look! How about we STOP trying to police the morals of everyone else and accept some personal responsibility for our own behavior. Do I think they should be fired? If there is specific policies that have been violated, yes. If no policies have been violated, then the issue should be left to fade into the background. I'm sure there are much more important issues facing this police department than a provocatively dressed waitress handling a firearm sitting on the trunk of a department vehicle. By the way 4c6, I agree, you'd be hard pressed to find 12 total supermondel types, male or female, in my area as well.

I agree with everything Cos says, and most importantly I agree with the above. Getting vetrans of any field to accept new and "different" things is sometimes close to impossible. There are those time when you make headway with a few and can use their influence to sway more. One of the important things you need to have them understand is that you're not trying to redesign the wheel, so to speak. Remember to point out that ALL advanced care is based on GOOD basic skills and assessment. I always point out to my basic classes, both EMT and CPR, that the first thing that is covered in AHA ACLS and PALS is BLS CPR! Without the basics, we can never move to the advanced.

Ruff, These type of providers are everywhere. Here are some opinions of my own. 1. What does the Medical Director think of these acusations? What do the PCR's reflect? Does this provider "fudge" evaluations, or do they actually document what they find? Ultimately, you come down to what you can prove as apposed to what is documented. 2. If patient families have witnessed this poor attitude, have them submit a formal letter of complaint to the squad. This will back up any discilpine you may take. Documentation is not just good for PCR's you know. Other crew members that have witnessed this may also submit incident reports. 3. From the attitude you report, it sounds like this provider needs to take a break from patient care. This sounds like typical burn out symptoms. It may be time to have this person take some time off, or change thier primary duties, if that is possible. It's all well and good to say that someone should be let go, but remember, it could be you some day. While we all think it won't happen to us, burn out is real and should be dealt with fairly and justly. We don't give second thoughts to providing CISD for large incidents, but mostly fail to see the result of the accumulation of weeks, months, or years of dealing with our chosen profession. Some of us handle it well, others do not. My final thought is this, there is a small percentage of providers in this industry, that are only here for the paycheck. While I admit, the paycheck makes it easier to do what we do, there should also be an eagerness to help your fellow man.

This is a very confusing and serious request. I havfe read the various responses from the other that have left their input, and would like to now leave mine. First, you need to clarify, this Medic, was he on the clock, i.e., being paid to respond to calls? If so, under may civil laws he is negligent for not responding. If not then, as an officer of the company, does he have a duty to respond when requested? This again would make him negligent. I am not sure of what the laws are where you are from, however, I am sure that your squad's legal advisor can give you a better understanding of what constitutes negligence when referring to failure to respond in your area. Second, what is the certification level of the responding providers? EMT-B, or EMT-Advanced(Intermediate)? I'm assuming the former. If this is so, why wasn't ALS dispatched initially along with the BLS unit? You report the call was dispatched as Chest Pain. This is clearly a call for ALS response. Finally, someone had mentioned that rapidly transporting the patient to definitive care is always an option. I both agree and disagree with this. If the transport time to the Hospital/ER would be less than the time to meet with an ALS rendezvous, then by all means apply the diesel. If the rendezvous will delay definitive care, transport direct to the ER. However if the rendezvous will not delay getting the patient to definitive care, by all means utilize this for the most positive patient outcome. I have the greatest respect for the many volunteers out there in both the EMS and Fire Services. We must all remember that some places cannot financially afford to have paid crews around the clock, if at all. As both a career and volunteer provider of both Fire and EMS service, I say to ALL of my fellows, keep up the good work!

I don't claim to be an expert, nor have I read all of the posts here so far, but I can pull from my 25+ years of experience and give MY OPINION on this subject. While I see alcohol use widely accepted and on the increase, I am also aware of some providers that do smoke weed occasionally. I would like to say, however, those that I know who smoke weed would do it even if they didn't work prehospital EMS. This just gives them a convienent excuse. I also think that "burn out" is used by many to explain their substance abuse. I personally work a moderately high volume ALS squad in an urban setting, and while I'll admit that I look at life from a distortedly dark point of view, that many in this field share, I do not drink, or do illegal drugs. I do take antidepressants, more to spare my family from the backlash of my psyche dealing with the things I witness. I however do not have trouble sleeping. Substance abuse for any reason, or due to any cause, has it's complications and will take it's toll eventually. I am becoming aware of an increase in emergency responders being prosecuted for DUI. Law enforcement agencies seem to be putting a halt to the old practice of giving "professional courtesy." Again, this is me and my opinions.

Sorry, but I don't quite follow. Who's protocol is this, it is NOT AHA BLS or ACLS as far as I'm aware.

I believe Exeter Ambulance is holding an AHA Core Class and BLS instructor class. 610-779-7687. I'm not sure when.

Tim, I'm a bit confused. In your original post, you state that he attends, or should I say, appears at station, for training courses, but does not participate in the training, and when he does he is disruptive. I also believe you stated he "passes the training because he's a volunteer." I hope that doesn't mean he is given a passing grade due to his volunteer status! This is EMERGENCY MEDICINE we are talking about. If he is not truely qualified, he should not be given a pass because he's a volunteer. Volunteer or paid status should not be a consideration when talking training. If you can't get management to understand that, ask them if they'd let him work on them or their family. Institute mandatory training levels and if he does not complete the classes successfully, he doesn't get the qualification. If he's not qualified he can't run on the units. Problem solved.

I have the opportunity to read Patient Care Reports (PCR) with narratives written by various people. Some providers chart a cardiac arrest with a brief paragraph and extensive flowsheet of treatment, others write novellas for a case of the sniffles. Personally, I like to chart the positive findings, touch on pertinent negatives, and chart any changes due to treatment rendered. I recently had a discussion with several providers about their habit of charting, "trachea is midline and there is no notable JVD." My point was that if the trachea WASN'T midline, or if there WAS JVD, you should have been charting some other notable findings way before you got that far. I have also found that your medical director may have some input as to what he would like to see in a narrative. One of mine likes to see that we chart "CAOX4" on refusals, even though the GCS is part of the recorded vital signs.

Sorry gang, I'm coming in late in this discussion. I am an AHA Instructor on both BLS and ACLS levels. My understanding of the intended audience for the hands, or compressions, only CPR is that it is only intended for heneral public, or lay person, Heartsaver CPR. It is being shown to HCP students so that if we come across someone doing it, we understand that it is not incorrect CPR. I also tell my students, that if they are off duty, like walking in a mall, and someone collapses, they can do it, but MUST do proper BLS CPR when on duty. If someone has already said all this, I'm sorry. Like I said, i'm coming in late.

I am looking for any assistance in this issue. My TCC is requiring all BLS Instructors to also carry a provider card. This is not a problem for me, however some of the older instructors seem to be disturbed about it. I am trying to determine if this is a TCC requirement or an AHA requirement. Can anyone help???